Stephanie Backof Holmes Kinnare, PSYCHOLOGIST

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY8730 Issued in FL

Practice address

12724 Gran Bay Pkwy W Ste 410
Jacksonville, FL 32258-9486

Phone

(904) 574-5200

NPI assigned

May 23, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stephanie B Holmes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1841637428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12724 GRAN BAY PKWY W STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589486",
            "telephone_number": "904-574-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12724 GRAN BAY PKWY W STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589486",
            "telephone_number": "904-574-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNARE",
        "first_name": "STEPHANIE",
        "middle_name": "BACKOF HOLMES",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HOLMES",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyler Thomas Kingsbury
• David Michael Kinker, DNP, APRN
• Samantha Rose Kinkopf, MA, LHMC (MH 20499)
• Isaac M Kinman, D.O.
• Kaycee Raine Kinnard
• Sherrye Kinnebrew, APRN
• Amanda Lynn Kinney, RD
• Kevin Kinney
• Jami Ann Rothe Kinnucan, M.D.
• Tristyn Kinser, MS, ATC, LAT

• Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.